EAACIMolecular Allergology User's Guide 2.0

Abstract

Since the discovery of immunoglobulin E (IgE) as a mediator of allergic diseases in 1967, our knowledge about the immunological mechanisms of IgE‐mediated allergies has remarkably increased. In addition to understanding the immune response and clinical symptoms, allergy diagnosis and management depend strongly on the precise identification of the elicitors of the IgE‐mediated allergic reaction. In the past four decades, innovations in bioscience and technology have facilitated the identification and production of well‐defined, highly pure molecules for component‐resolved diagnosis (CRD), allowing a personalized diagnosis and management of the allergic disease for individual patients. The first edition of the “EAACI Molecular Allergology User's Guide” (MAUG) in 2016 rapidly became a key reference for clinicians, scientists, and interested readers with a background in allergology, immunology, biology, and medicine. Nevertheless, the field of molecular allergology is moving fast, and after 6 years, a new EAACI Taskforce was established to provide an updated document. The Molecular Allergology User's Guide 2.0 summarizes state‐of‐the‐art information on allergen molecules, their clinical relevance, and their application in diagnostic algorithms for clinical practice. It is designed for both, clinicians and scientists, guiding health care professionals through the overwhelming list of different allergen molecules available for testing. Further, it provides diagnostic algorithms on the clinical relevance of allergenic molecules and gives an overview of their biology, the basic mechanisms of test formats, and the application of tests to measure allergen exposure.

Sensitization patterns to cat molecular allergens in subjects with allergic sensitization to cat dander

“…24,43 Lastly, cross-reactivity patterns to cat and horse allergens should be taken into account in future studies since it has been commonly described in subjects with allergy to furry animals. 4…”

“…We defined allergen protein families as follows: lipocalins (Fel d 4 and Fel d 7), albumin (Fel d 2), and secretoglobin (Fel d 1). 4,9 Sensitization patterns were characterized for cat molecular allergens as below 31 :…”

“…Sensitization patterns were subdivided into three groups according to allergen protein families: lipocalins (Fel d 4 and Fel d 7), albumin (Fel d 2), and secretoglobin (Fel d 1). 4 Age, sex, smoking status, BMI, dust exposure, farm live, family allergy/asthma history, and cat ownership were demonstrated for the random sample and the asthma sample, including subsamples for those who were sensitized to lipocalins, albumin, and secretoglobin (Table 1). Younger subjects sensitized to secretoglobin were more likely to be from the asthma sample than older subjects (Table 1).…”

“…On the other hand, allergic sensitization towards cat dander and molecular allergens measured via IgE positivity does not necessarily translate into clinical allergy; thus, clinical cat allergy itself may require further validation with clinical evaluation. 4 Nevertheless, IgE positivity has been demonstrated and is widely used as an indicative marker for future allergy risk and allergic airway inflammation in epidemiologic studies. 24,43 Lastly, cross-reactivity patterns to cat and horse allergens should be taken into account in future studies since it has been commonly described in subjects with allergy to furry animals.…”

“…2,3 Additionally, subjects without a cat could also be exposed to cat allergens via secondhand transmission, such as in public transportation and schools. 4,5 Therefore, the development of cat allergy is also associated with the number of cat owners in the community besides the primary exposure at households. 6,7 The prevalence of cat sensitization in the United States is around 12% among subjects ≥6 years old.…”